The present invention relates generally to the field of respiratory care systems for intubated patients.
Proper long-term respiratory care of intubated patients requires that multiple medical procedures be performed on the patient. Such procedures may include, for example, ventilation of the patient""s lungs; aspiration of secretions from the lungs; oxygenation of the lungs; elimination or reduction of residual CO2 from the lungs; visual inspection of portions of the respiratory system; sampling sputum and gases; sensing parameters such as flow rates, pressure, and temperature of gases within the respiratory system; and/or the administration of medication, gases, and/or lavage.
In the majority of these procedures, a medical treatment device, such as a catheter assembly, is connected to a patient""s artificial airway, for example a tracheostomy tube or endotracheal tube. A connecting member, such as an adapter, manifold or other like member, may be attached to the proximal end of the artificial airway and the medical treatment device is inserted through the adapter or manifold and into the artificial airway. The manifold may include a variety of ports through which any manner of medical treatment device may be inserted into the patient""s respiratory system for carrying out any combination of the procedures mentioned above.
During certain procedures, it is important that the medical treatment device be precisely positioned in the patient""s respiratory system. For example, when using a gas insufflation catheter to oxygenate a patient""s lungs, it is necessary to precisely position the catheter at the carina of the lung and maintain that catheter in that position. Similarly, it may be necessary to precisely place a biopsy device, sampling device, or monitoring device into the patient""s respiratory system and maintain the positioning of the device for the duration of the procedure.
One concern with current medical devices is that it is difficult to ensure that such devices are held in position within the patient""s respiratory system when inserted through the artificial airway. This is particularly the case when different procedures must be performed simultaneously through the artificial airway requiring at least one medical treatment device to be maintained in position while another medical procedure is conducted with a second medical treatment device. The present invention provides a reliable and relatively easy to use clamping assembly for establishing and maintaining the position of a medical treatment device inserted through a patient""s artificial airway.
Objects and advantages of the invention will be set forth in part in the following description, or may be obvious from the description, or may be learned through practice of the invention.
As used herein, the phrase xe2x80x9cartificial airwayxe2x80x9d includes devices such as tracheostomy tubes, endotracheal tubes, and the like, that define an artificial ventilation path into a patient""s respiratory system. The present invention is not limited to use with any particular type of artificial airway.
The present invention is directed generally to a respiratory care assembly particularly suited for use with a ventilating system. In particular, the invention relates to a unique clamping assembly incorporated in the respiratory care assembly. The clamping assembly provides the clinician with a reliable and effective assembly for maintaining the position of a medical treatment device that has been inserted through an artificial airway and into a patient""s respiratory system. The clamping assembly holds the medical treatment device in its position in the respiratory system until released by the clinician.
The clamping assembly includes first and second axially aligned members. These members may be considered as xe2x80x9cproximalxe2x80x9d and xe2x80x9cdistalxe2x80x9d members depending upon their orientation in the respiratory system. At least one of the first and second members is movable relative to the other respective member. An axial channel is defined through the first and second members and is configured for axial sliding receipt of a medical treatment device, such as a catheter tube of any manner of catheter assembly.
A clamping member is disposed in-line with the first and second axially aligned members. The clamping member defines at least a section or portion of the channel through which the medical treatment device passes. The clamping member has an un-clamped configuration wherein the treatment device is slidable through the channel, and a clamping configuration wherein the clamping member clamps upon and prevents axial movement of the medical treatment device through the channel. The clamping member is operably connected to each of the first and second members so that relative movement between the members actuates the clamping device.
The first and second members may be threadedly engaged such that threaded rotation of one member results in relative axial displacement between the members. In this embodiment, the clamping member may be a compressible annular sleeve member having opposite axial ends that are connected with the first and second members, respectively. A treatment device, such as a catheter tube, passes through the annular sleeve member. The annular sleeve member is disposed in a restraining recess such that upon relative axial movement of the first and second members, the annular sleeve is compressed axially. Because the sleeve is restrained in a fixed diameter recess, radial expansion of the sleeve resulting from its axial compression is directed radially inward resulting in reduction of the inner diameter of the annular sleeve thereby causing the sleeve to clamp upon the treatment device disposed therethrough. To release the treatment device, the clinician simply moves the first and second members in the opposite direction. For example, if the first and second members are threadedly engaged, the clinician rotates the movable member in the opposite direction to release the treatment device.
The first and second members include connecting or mating members at their respective ends so that the clamping assembly may be connected permanently or removably in-line in a respiratory system. For example, the proximal member may include a connecting member configured for permanent or removable engagement with the distal end of a catheter assembly. Similarly, the distal member may include a connecting member configured for connection to a patient""s artificial airway. It should be understood that connection of the assembly to an artificial airway may be accomplished through an intervening mechanism, such as a manifold having one or more ports to which the distal member is connectable. For simplicity and ease of connection, the distal connecting member may be a distal extension configured to be pressed into a receiving port of the manifold.
To aid the clinician in operation of the clamping assembly, it may be desired to incorporate a gripping member on the movable or rotatable member. The gripping member may be, for example, a grip ring having a plurality of grip enhancing protrusions, or the like. The grip ring may define a maximum outer diameter of the respective proximal or distal member.
In one embodiment of the clamping assembly, the proximal member is the movable member and the distal member is held stationary relative to the patient""s artificial airway. It should be appreciated that this is but one working embodiment. It is just as feasible for the distal member to be rotatable or movable, or for both members to be independently rotatable or movable.
It should also be appreciated that the clamping member need not necessarily be actuated by axial movement between the proximal and distal members. For example, it is within the level of those skilled in the art to configure a clamping member that operates with a pure rotational or twisting motion. The axially compressible annular sleeve discussed herein is but one embodiment of a clamping member that works particularly well with threaded axial displacement between the first and second members. The present invention is not, however, limited to a compressible annular sleeve clamping member.
It should be appreciated that the clamping assembly according to the invention is not limited in its application or use with any particular medical treatment device. The clamping sleeve and axial channels defined through the first and second members may be sized and configured to accommodate any manner of conduit, tube, or the like, depending on the medical procedure and appropriate medical device. In this description, the medical device is a catheter assembly having a catheter tube that is slidable through the clamping assembly. It should be appreciated that this is merely one embodiment of the invention and is presented for purposes of explaining the invention.
The present invention is also drawn to any manner of a respiratory care assembly incorporating the novel clamping assembly described herein. A respiratory care assembly according to the invention utilizes the clamping assembly to introduce any manner of medical treatment device, such as a catheter assembly, through a patient""s artificial airway. The particular type of medical treatment device is dictated by the desired medical procedure. For example, in a procedure wherein it is desired to aspirate secretions from a patient""s lungs, the respiratory care assembly may include a suction catheter assembly incorporating a clamping assembly of the present invention. The suction catheter assembly includes a catheter tube that is slidable through the axial channel defined in the clamping assembly and through the patient""s artificial airway to a desired position or location in the respiratory tract for suctioning secretions from the patient""s lungs. Once the catheter has been properly placed by the clinician, it is a relatively simple procedure for the clinician to rotate or move the proximal member of the clamping assembly to securely lock the catheter in its axial position.
In another example, a gas insufflation catheter may be required to oxygenate a patient""s lungs. The insufflation catheter utilizes a catheter tube positioned at the cornea of the lung to administer oxygen directly into the lung. Once the clinician has properly positioned the catheter at the cornea of the lung, the catheter is axially locked in this position by the clinician simply rotating the proximal member. The catheter is securely held in position until the clinician rotates the proximal member in the opposite direction and withdraws the catheter.
It should thus be appreciated that the invention is not limited to any particular type of medical treatment device or medical procedure, but is useful in any application wherein it is desired to securely position and hold a medical treatment device in a desired position within the patient""s respiratory system.